目的: 观察准分子激光原位角膜磨镶术 (Laser in situ keratomileusis,LASIK) 术后视疲劳及眼调节功能的变化,评价七叶洋地黄双苷滴眼液治疗LASIK术后早期视疲劳的临床效果。方法: 120例(240只眼)近视眼患者,进行LASIK手术,术后分成七叶洋地黄双苷滴眼液治疗组和对照组各60例(120只眼),每组又分为: A 组低度近视组(0～-3.0 D),B 组中度近视组(-3.25～-6.0 D),C 组高度近视组(≥-6.25 D)。术后第7、14和28 d观察: 1)主观性指标: 视疲劳主观症状问卷评分。2)客观性指标: 双眼调节幅度,调节滞后量,正/负相对调节。结果: 1)两组术后第7 d视疲劳症状评分上升,视疲劳症状明显加重,第14 d评分有所下降,症状逐渐改善,第7、14 d治疗组症状均较对照组轻,且均有显著性差异(p＜0.05),第28 d视疲劳症状评分明显下降,且低于术前,症状明显改善,两组低度近视无显著性差异(p＞0.05),中、高度近视有显著性差异(p＜0.05)。2)两组术后第7 d双眼调节幅度明显降低,第14 d有所提高,第28 d明显提高,并高于术前,术后第7、14、28 d,两组低度和高度近视差异无显著性(p＞0.05),中度近视差异有显著性(p＜0.05)。3)两组负相对调节术后第7、14和28 d两组差异均无显著性(p＞0.05)。4) 两组正相对调节术后第7 d明显下降,两组低、高度近视差异无显著性(p＞0.05),中度差异有显著性(p＜0.05),第14 d正相对调节有所提高,第28 d明显提高,并高于术前,两组第14、28 d正相对调节差异均无显著性(p＞0.05)。5)两组术后第7 d调节滞后量减小,且两组差异均无显著性(p＞0.05),术后第14 d调节滞后量有所增加,低度和高度近视差异无显著性(p＞0.05),中度近视差异有显著性(p＜0.001)。第28 d调节滞后量增加,并略高于术前,且两组低、中度近视差异有显著性(p＜0.05),高度近视差异无显著性(p＞0.05)。结论: 七叶洋地黄双苷滴眼液能够治疗LASIK 术后不同程度近视的早期视疲劳,中度近视的视疲劳效果最佳。

Objective: To observe asthenopia and the change of eye adjustment functions after laser in situ keratomileusis (LASIK) and to evaluate the clinical effect of Augentropfen Stulln Mono Eye Drops on early postoperative asthenopia. Methods: 120 cases of myopic (240 eyes) are observed after LASIK. They are divided into 2 groups after LASIK: one with Augentropfen Stulln Mono Eye Drops treatment and the other as a control group, 60 persons (120 eyes). Inside each group, they are further divided into A group low (0.00～3.00 D), B group medium (3.25～6.00 D) and C group high (6.25 D or above) myopia subgroups. They will be examined on the 7th, 14th and 28th day after LASIK. Observation indexes: 1) the subjective indicators: asthenopia symptom scores. 2) objective indicators: the amplitude of binocular accommodation, the lag of accommodation and positive/negative relative accommodation. Results: 1) The increasing scoring of asthenopia in both groups on the 7th day after LASIK suggests the symptoms significantly worsened. After 14 days, the scores decreased slightly, indicating a gradual recovery. Compared with the control group, the symptoms of targeted group are lighter, and the two groups demonstrate significant difference (p＜0.05) on both 7th and 14th day after LASIK. After 28 days, the scores of asthenopia drop dramatically and are even lower than pre-LASIK. The symptoms improve remarkably. No significant difference (p＞0.05) between two low myopia subgroups is found. However, there are significant differences (p＜0.05) between middle and high myopia subgroups. 2) The amplitudes of binocular accommodation reduce on the 7th day after LASIK and raise mildly on the 14th day after LASIK. It increases observably on the 28th day after LASIK and is even higher than pre-operation. On the 7th, 14th and 28th day after LASIK, there is no significant difference (p＞0.05) between two low and two high myopia subgroups whereas there are significant differences (p＜0.05) between two middle myopia subgroups. 3) From the perspective of negative relative accommodation (NRA), all data on 7th, 14th and 28th day after LASIK indicate no significant difference between myopia subgroups (p＞0.05). 4) From the perspective of positive relative accommodation (PRA), both groups drop greatly on the 7th day post-operation. The two low and two high subgroups display no significant differences (p＞0.05) while the two middle subgroups present significant difference (p＜0.05). The PRA on the 14th day rises visibly and that on 28th day increases dramatically, which is even higher than pre-operation. Differences of PRA are insignificant in both groups on the 14th and 28th day (p＞0.05). 5) The lag of accommodation on the 7th day after LASIK reduces and there is no significant difference (p＞0.05) between two groups. It improves on the 14th day. Meanwhile, there is no significant difference (p＞0.05) between two low and two high myopia subgroups whereas a much more significant difference (p＜0.001) can be observed between two middle myopia subgroups. On the 28th day, the lag of accommodation raises, and slightly higher than pre-operation. In addition, significant differences can be found between both two low and two middle myopia subgroups (p＜0.05) and no such feature appears in two high myopia subgroups (p＞0.05). Conclusion: Augentropfen Stulln Mono Eye Drops demonstrate a great influence on relieving post-LASIK early asthenopia. It has effects on myopia with all different levels and the best effects rest on middle myopia.